If you read the WebMD report, you'll notice all sorts of advertisements from drug companies for statin cholesterol drugs ("Cholesterol health center"; "Understanding Cholesterol Numbers"; "There are two sources of cholesterol: food and family"), Niaspan (which I used to support but have been discouraged by the Kos companies excessively profiteering methods and recent big Wall Street sellout).

The government advice to "eat more healthy whole grains" is not off-base.  But that's not what Americans did.  Instead they ate more fructose and replaced saturated fats with more polyunsaturated fats.  This is totally fundamentally different than eating a low-fat, high-carbohydrate diet like that of the rural Zulu tribe studied by T.L. Cleave or the Africans studied by Denis Burkitt and Hugh Trowell that were diabetes and obesity-free.  

Americans are still not even coming close to the grain consumption of a century ago, when such diseases were exceedingly rare.

This video is very good:

"Vitamin D and Diabetes-Can We Prevent it?"

http://www.youtube.com/watch?v=wTtmvMvgfl0

At this link you'll find the slides of a short presentation on
The Influence of high vs. low sugar cereal on children's breakfast consumption.
There are some surprising findings.

I found it at Cerealfacts.org website

The situation in the UK is much the same. The breakfast cereals most likely to find at discounted prices are those with the most sugar.

It's  often the case the choice of cereal going into the trolley is made by the child rather than the parent. There should be more restrictions on the promotion of pre-sweetened cereals to kids.

In my early 60s I notice that I don't get much "kick" out of sugary foods as I might have earlier.  I've gotten to the point where I can't believe the amount of sugar in say cookies or ice cream...which I no longer buy.  

I do now take several phyto-extracts...pomegranate...blueberry...cocoa...resveratrol...green tea...grape seed...etc.

Pomegranate at least has been shown to moderate insulin response and maybe reverse atherosclerosis.

http://www.lef.org/LEFCMS/aspx/PrintVersionMagic.aspx?CmsID=114814

Great post!
I've just blogged about my eating history too...  years of low-fat, high starch, high fruit eating led me to the brink of diabetes. I'm amazed I survived childhood!

Interesting, but this leaves out neogenesis within the pancreas. Assuming that glucose intake is reduced, wouldn't new beta cells be undamaged and have full functionality? [Unless progenitor cells are also damaged...]

Wouldn't this be more along the lines of adult onset type 1 diabetes (insulin dependent)?  It seems like that is growing too but the real swell seems to be in Type 2 diabetes where you produce copious amounts of insulin but your tissues are resistant to it.

"Interesting, but this leaves out neogenesis within the pancreas. Assuming that glucose intake is reduced, wouldn't new beta cells be undamaged and have full functionality? "

That explains why my obese elderly mom has normal blood sugars even though she has always eaten diet high in simple carbs.

Dr. A, your previous diet was indeed low fat and starch based but there was not much actual, real food in it!  I am missing the connection both here on this thread and in your blog, between people eating manufactured, food like substances that don't have much fat in them and are loaded w/ refined/highly processed starch carbs w/ almost zero fiber or nutrients in them, and the eating of actual whole grains, either fully intact or minimally processed.

"Wouldn't this be more along the lines of adult onset type 1 diabetes (insulin dependent)? It seems like that is growing too but the real swell seems to be in Type 2 diabetes where you produce copious amounts of insulin but your tissues are resistant to it."

If you haven't already, check out Jenny Ruhr's blog, Diabetes Update, and her related website, Diabetes 101.  Type II is being subdivided according to short and long-term beta cell function and insulin resistance.  Different genes cause different impairments.  Emerging is MODY (mature onset diabetes of the young), or type 1.5.  A defining characteristic is that the ability of the pancreas to secrete insulin declines slowly over time, rather than suddenly as in type I, but it declines no matter what the treatment.

I am a Ketosis Prone Type 2 diabetic and it isn't necessarily true that glucose toxicity leads to permanent loss of pancreas functioning.

Typically, we will lose all pancreas secretion and will go DKA, at that point we are essentially type 1's. We need insulin to survive but after 2 to twelve weeks of normal blood sugars we can be taken off insulin and we will have near normal blood sugars.

Weird, yes, but there are thousands of us out there so this isn't uncommon.

Narrative Review: Ketosis-Prone Type 2 Diabetes Mellitus
http://www.annals.org/content/144/5/350.abstract

My blog has more information, if you are interested.

We seem to be severely intolerant of carbs so I too wonder what would have been the case, if years ago the carbs were taken out of my diet.

Michael Barker - your blog is fascinating. Thanks for the pointer. Will you be allowing comments?

What a great resource!

Matt Stone said...
"The government advice to "eat more healthy whole grains" is not off-base. But that's not what Americans did." The public were conned. Manufacturers turned whole grains into dust and formed the dust into junk. Because everything that was in the grain was in the junk, they called the junk "whole grain".

Sadly, this is what happened to me. I had glucose problems by age 15, but they told me for years I was fine. There was less information available in those days. I stopped all soda and junk, but it was too late, my fate was sealed. My pancreas and teeth were damaged. Somehow I managed to eat fruit without getting headaches years later, so I thought fruit in moderation was healthy. I though my fatigue was from my mercury fillings, but now I realize some of my fatigue was from fruit sugar. I blame society and my parents, although I forgive my parents. I was fed tons of soda and every type of high glycemic junk food you can imagine.

It's about time SOMEBODY started telling the truth about the heart disease "plumbing" racket!

This is all so true. What makes me even more mad is my Dad is on some cholesterol lowering drug and no matter how much evidence I show against it he does not believe that his doctor would not do what is best for him. Makes me sick when I think about it.

I am currently in a battle with my "preventative" cardiologist.  she just handed me a bunch of Crestor due to a very high Lp(a) and family history of heart disease.  I have gone round and round with her about statins and she was willing to go the Niacin route first.  I was convinced that would work but something very strange occurred.  I don't mind the Niacin flush at all and I did take with food, aspirin, the whole 9 yards.  After being on the Niaspan for 12 days, I suddenly broke out into horrible hives all over my body and now 3 weeks later I still have some lingering rash/hives on my arms.  My diet and exercise program couldn't be better - I walk 6 miles a day, yoga 3 times a week, eat whole foods only, drink lots of water and I am just not sure what to do next.  My Lp(a) number is 135 and my total cholesterol is 267 with a not so good "ratio".  If anybody has any suggestions or comments I would love to hear them!

Judy, make sure you take a close look at the hormones (estrogen, DHEA, thyroid, etc.), as these can influence Lp(a) to a pretty large degree.

High dose EPA/DHA from fish oil is also really important. Consider up to ~6,000 mg EPA + DHA daily.

Consume raw nuts and seeds. Almonds and ground flaxseed are great, and can help in dropping Lp(a).

L-carnitine can help in lowering Lp(a), at least by a little bit.

Not sure what you're including when you say your diet is made up of "whole foods." If this refers to things like "whole wheat," then that's problematic. Based on the research I've seen, those of us with Lp(a) (and yes, I am one of them too) are quite a bit more sensitive to the carbs. Eat carbs, and your Lp(a) goes up. Eat lower carbs, higher fat (particularly saturated), and your Lp(a) goes down. I would be loving on the coconut oil if I were you (and that's exactly what I do).

As for exercise, I would start changing it up. That's an awful lot of walking, and it's not going to create the hormonal response that you need. The real benefit is in the high intensity stuff. Short, vigorous sprints, squats, that sort of thing. Check out www.crossfit.com for some idea of what I'm talking about.

Judy,
I second what David says above--it sounds like good, solid advice.
I would add 3 things to the supplement category--Vitamin C (min 6000mgs/day) L-Lysine (min 6000mgs/day) and NAC, (min 1200mgs/day)
The Vitamin C and L-Lysine combination is I'm sure you know, the Pauling-Rath formula--it's been around a long time, many swear by it, but it's never been clinically double-blind tested.  The NAC, I recently learned, is possibly the most powerful natural Lp(a) inhibitor out there, for now, anyway.  I was so swayed by what I read about it, I purchased a couple of bottles of it to add to Pauling-Rath, since I, too, am sometimes irked by the Niacin flushes I begin experiencing as I get closer to the 500mg dose--and this is after weeks of slowly titrating the dose so that I may avoid that uncomfortable event.
Judy, also keep in mind, I've always read that 1)It's better for women to have higher cholesterol levels and 2) up until a few years ago, a cholesterol level of over 300 was considered high.  Now that '200' is the new '300', there seems to be quite a market for new prescriptions, nu?
Adam

The Pauling/Rath therapy is indeed intriguing. Before I discovered Dr. Davis and the TYP program, I thought that the Pauling therapy was the answer to heart disease.

I now believe and am convinced that there's more to it than that, and I think Dr. Davis has one of the best, most comprehensive programs for heart disease out there.

However, this is not really a criticism, and I remain convinced that there is value to the Pauling/Rath therapy. It makes so much sense, at least theoretically in terms of reducing Lp(a), and it has quite a bit of anecdotal evidence behind it (not to mention the research carried out by Rath, complete with CT scans). It seems like the experience of doctors using this therapy with their patients varies quite a bit, though. Some doctors swear by it, while others say it just doesn't work. It's only for this reason that I usually don't bring it up until I've brought other ideas to the front that I know are very effective.

I've got my dad on the Pauling therapy, along with these other things (basic TYP stuff), and we'll be getting his Lp(a) rechecked soon. Should be interesting to see how much it has come down, though I won't know which factor (niacin, diet, carnitine, fish oil, etc.) is creating the most change. I just decided to hit it with everything we've got.

Oh, and it's the same with the NAC. There are pockets of stunning success, but there's also worry about long term safety and the development of pulmonary hypertension. Is that a real danger? I don't know. I would guess not, personally, but at the same time I'd rather mention the "tried and true" methods first that have the most overall benefit.

I'm glad the Pauling therapy was brought up, here. I think it definitely should be looked into more, and people need to be aware of it as an option that many are having success with.

David

This may be of interest to those who may want to reduce the risk of venous thromboembolism (VTE) with a statin (Crestor):

http://www.usatoday.com/news/health/2009-03-29-statin-clots_N.htm

Statin Crestor lowers risk of deep-vein clots

"ORLANDO — (3/30/09) Researchers have shown for the first time that a potent cholesterol-lowering drug, Crestor, reduces the risk of deep vein thrombosis, or "economy-class syndrome," caused by potentially lethal blood clots that start in the veins and migrate to the lungs, sometimes after long flights.

The evidence, out today, is the latest to emerge from the landmark JUPITER trial, which showed that statin treatments can cut in half the risk of heart attacks and strokes even in people with normal cholesterol levels."

No other medicine has been shown to safely prevent these blood clots, which occur in at least 350,000 people a year and kill as many as 100,000 of them. The standard remedy once thrombosis has occurred is the drug warfarin, which, unlike statins, can promote bleeding.

Statins are "a remarkably benign therapy," says senior investigator Paul Ridker of Brigham and Women's Hospital in Boston. "The thing that's really exciting is that there is no bleeding risk."

Other studies have hinted that statins also reduce clot formation, but their power to prevent deep vein thrombosis was unknown. Ridker and his co-workers decided to use JUPITER to test the theory. A total of 17,802 people were randomly assigned to treatment and placebo groups. They were followed for nearly two years, on average.

Deep vein thrombosis occurred in 34 patients taking Crestor and 60 people who were taking placebos, indicating that treatment reduced the risk of clots by 43%. Ridker says he believes that other statins would also reduce the risk.


What I take from this;

The dose of Crestor in JUPITER was 20mg.  Paul Ridker said that this is a remarkably benign therapy?  I think not, given Dr. Davis' descriptions of intolerable side effects that will inevitably occur to the majority of people at this dosage.  I've never used Crestor, but I have used 10mg Zocor and developed mild myopathy in my legs after only three weeks, so I'll take his word that I would be a poor candidate.

I think the most interesting part of the press release is that JUPITER (like the other statin trials) in no way confirms what mechanism may be behind the reduced risk of VTE.  Could it be due to a lowering of vascular inflammation as indicated by a lower CRP?  That certainly makes sense.  It would be really great to get a definitive answer, since CRP can be effectively managed by other means than taking such a strong statin like Crestor.

AstraZeneca's press release of CRESTOR® REDUCED RISK OF BLOOD CLOTS IN THE VEINS (3/29/09):

http://www.prnewswire.com/mnr/astrazeneca/37394/

AstraZeneca’s (AZN.L)(AZN.N) powerful cholesterol drug Crestor cut the risk of dangerous blood clots in the vein by 43 percent in a large study, researchers said on Sunday.

After being on the Niaspan for 12 days, I suddenly broke out into horrible hives all over my body and now 3 weeks later I still have some lingering rash/hives on my arms.

Took it for a year or so, but now I need it again and my insurance wont pay for it and my other medicines are over $400.00 a month and they want $160.00 more for Crestor. We just can't do it.